Soluble fiber and nondigestible carbohydrate effects on plasma lipids and cardiovascular risk

Consumption of dietary fiber and APOA5 genetic variants in metabolic syndrome: baseline data from the Korean Medicine Daejeon Citizen Cohort Study

BACKGROUND

Consumption of dietary fiber has been suggested as an important aspect of a healthy diet to reduce the risk of metabolic syndrome (MetS), including cardiovascular disease. The role of fiber intake in MetS might differ by individual genetic susceptibility. APOA5 encodes a regulator of plasma triglyceride levels, which impacts the related mechanisms of MetS. This study investigated the association between dietary fiber and the risk of MetS, assessing their associations according to APOA5 genetic variants.

METHODS

A total of 1985 participants aged 30-55 years were included from a cross-sectional study based on the Korean Medicine Daejeon Citizen Cohort study at baseline (2017-2019). Dietary fiber intake was measured using a semiquantitative food frequency questionnaire. The APOA5 polymorphisms (rs2266788 A > G, rs662799 A > G, and rs651821 T > C) were genotyped using the Asia Precision Medicine Research Array. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs).

RESULTS

A higher consumption of dietary fiber was associated with a lower prevalence of MetS (P = 0.025). Among the components of MetS, an inverse association with dietary fiber was observed in increased waist circumference (OR, 95% CI = 0.60, 0.41-0.88, P for trend = 0.009) and elevated triglycerides (OR, 95% CI = 0.69, 0.50-0.96, P for trend = 0.012). Regarding the interaction with APOA5 genetic variants, a stronger association with dietary fiber intake was shown in G allele carriers of rs662799 than in A/A carriers (OR, 95% CI = 2.34, 1.59-3.44, P for interaction = 0.024) and in C allele carriers of rs651821 than in T/T carriers (OR, 95% CI = 2.35, 1.59-3.46, P for interaction = 0.027).

CONCLUSIONS

The findings of this study suggest that the benefits of dietary fiber on the risk of MetS could be modified by genetic variants of the APOA5 gene, providing a more effective strategy for preventing MetS.

Assessment of Nutrients Intake in Pediatrics with Type 1 Diabetes and Dyslipidemia in Jordan

Background

Dyslipidemias are disorders of lipoprotein metabolism that occur during childhood and adolescence, often persist into adulthood, and increase the risk of developing atherosclerotic lesions. This study aimed to assess the potential association between nutrient intake and dyslipidemia in Jordanian pediatric patients diagnosed with type 1 diabetes mellitus.

Methods

This cross-sectional study was conducted in Amman, Jordan, and involved 90 children and adolescents diagnosed with type 1 diabetes mellitus. Caregivers provided the following data: sex, age, type and dose of insulin, age at onset of type 1 diabetes, and level of physical activity. Anthropometric measurements were obtained using calibrated scales, and CDC growth charts were used to assess participants' body weight status. Nutrient intake was estimated using a 120-item food frequency questionnaire (FFQ) previously validated in Jordanian children and adolescents. Serum lipid levels, including total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), were measured. Binary logistic regression was used to assess the relationship between nutrient intake and dyslipidemia.

Results

The results indicated that 36.7% of study participants had dyslipidemia. There were no significant differences in nutrient intake between dyslipidemic and normolipidemic individuals, except for a significantly higher median intake of vitamin B12 in the dyslipidemic group compared to the normolipidemic group (3.6 versus 2.7 µg, P-value = 0.046).

Conclusion

This study found no significant association between the prevalence of dyslipidemia and nutrient intake in children and adolescents diagnosed with type 1 diabetes mellitus.

Vegetable and Fruit Intake and LOX-Index in Japanese Municipal Workers

Vegetable and fruit intake has been reported to be associated with decreased risk of cardiovascular disease. To date, however, no study has examined the association between vegetable and fruit intake and LOX-index, which reflects the progression of atherosclerosis and is a predictive biomarker of stroke and coronary heart disease. Here, we examined the cross-sectional association between vegetable and fruit intake and LOX-index in Japanese municipal workers. Participants were 338 workers (166 men and 172 women aged 19-71 y) with no history of serious disease who participated in a health and nutrition survey. Vegetable and fruit intake was assessed using a validated brief self-administered diet history questionnaire. LOX-index was calculated by multiplying serum concentrations of the soluble form of lectin-like oxidized LDL receptor-1 by those of LOX-1 ligands containing apolipoprotein B. Multiple regression analysis was used to estimate the geometric mean of LOX-index according to tertile of vegetable and/or fruit intake. Total vegetable and fruit intake was associated with a trend toward decreased LOX-index after adjustment for covariates (p for trend=0.067). In stratified analyses by sex, a significant inverse association between total vegetable and fruit intake and LOX-index was observed in women (p for trend=0.023), whereas such association was not observed in men (p for trend=0.70). None of the intakes of vegetables, fruit, green and yellow vegetables, or other vegetables was associated with LOX-index. Our results suggest that higher intake of total vegetables and fruit is associated with a lower LOX-index in Japanese women.

Association Between Dietary Fiber Intake and Cardiometabolic Risk Factors in Adolescents in the United States

OBJECTIVE

To determine the association between dietary fiber intake and markers of cardiometabolic risk in adolescents, with blood pressure (BP) as the primary outcome of interest and secondary outcome measures including other established markers of childhood cardiometabolic risk, such as obesity, lipids, albuminuria, estimated glomerular filtration rate (eGFR), and uric acid.

STUDY DESIGN

Dietary fiber intake was assessed by two 24-hour dietary recall interviews, which were averaged and corrected for body weight. Logistic and linear regression models were used to analyze the cross-sectional association between dietary fiber and cardiometabolic markers. Participants aged 13-17 years in the National Health and Nutritional Examination Survey 2009-2018 who completed a 24-hour dietary recall survey were included. Exclusion criteria included pregnancy, small for gestational age status, and history of major health comorbidities.

RESULTS

In fully adjusted regression models, low dietary fiber intake was significantly associated with greater diastolic blood pressure (β = -13.29; 95% CI, -20.66 to -5.93), body mass index z-score (β = -0.91; 95% CI, -1.47 to -0.34), and uric acid (β = -0.80; 95% CI, -1.44 to -0.16).

CONCLUSIONS

The association found between low dietary fiber intake and poor childhood cardiometabolic risk markers indicate a need for prospective studies using fiber intake as a dietary intervention in childhood and as a tool for prevention of many chronic conditions.

Longitudinal trends in lipid profile in indian children and youth with type-1 diabetes: a 5-year follow up from a single centre

INTRODUCTION

High prevalence of dyslipidaemia in children and adolescents with type-1 diabetes (T1D) places them at increased risk of developing atherosclerosis leading to mortality caused by cardiovascular disease(CVD). Thus, screening for fasting blood lipids when diabetes is stabilized in children aged 11 years and above is routinely recommended with follow-up every 5 years.

OBJECTIVES

(1) To characterize the lipid profile of children and adolescents with respect to diabetes duration. (2) To describe longitudinal changes in lipid profile over a 5-year period in patients with T1D.

METHODS

This longitudinal 5-year follow-up study included 112 patients with T1D aged 3-18 years. Demographic data, anthropometry and laboratory measurements were performed using standard protocols at baseline and endline. P value < 0.05 was considered significant.

RESULTS

The prevalence of dyslipidaemia in our study was 49.5% with abnormal LDL as the most frequently deranged parameter. Duration of illness played a major role in deterioration of lipid profile mediated by triglyceride and VLDL. Duration of illness and fibre intake in diet significantly predicted the change in lipid profile which were driven by triglycerides and VLDL. Glycemic control, insulin sensitivity and serum TSH also significantly altered components of lipid profile with no impact on overall dyslipidaemia. A total of 6.5% subjects had LDL concentrations >130 mg/dl and the same proportion had non-HDL cholesterol concentrations >145 mg/dl at baseline while at endline, 11.9% subjects had LDL concentrations >130 mg/dl and 15.6% subjects had non-HDL cholesterol concentrations >145 mg/dl. 28.6% subjects with LDL > 130 mg/dl and non-HDL cholesterol >145 mg/dl at baseline had persistently elevated concentrations while 10.3% and 14.4% additional subjects developed elevated LDL and non-HDL cholesterol concentrations respectively during the study period.

CONCLUSIONS

The deterioration of lipid profile in T1D, due to increase in disease duration was chiefly mediated by increase in serum triglyceride and VLDL concentrations which may be prevented by improving glycaemic control, insulin sensitivity and fibre intake in diet.

Healthy plant-based diets improve dyslipidemias, insulin resistance, and inflammation in metabolic syndrome. A narrative review

Plant-based diets (PBDs) have become very popular in recent years and have been identified as a dietary strategy associated with protection against chronic disease. However, the classifications of PBDs vary depending on the type of diet. Some PBDs have been recognized as healthful for their high content of vitamins, minerals, antioxidants, and fiber, or unhealthful if they are high in simple sugars and saturated fat. Depending on this classification, the type of PBD impacts its protective effects against disease dramatically. Metabolic syndrome (MetS), characterized by the presence of high plasma triglycerides and low HDL cholesterol, impaired glucose metabolism, elevated blood pressure, and increased concentrations of inflammatory biomarkers, also increases the risk for heart disease and diabetes. Thus, healthful plant-based diets could be considered favorable for individuals having MetS. The different types of plant-based diets (vegan, lacto-vegetarian, lacto-ovo-vegetarian, or pescatarian) are discussed with a focus on specific effects of dietary components in maintaining a healthy weight, protecting against dyslipidemias, insulin resistance, hypertension, and low-grade inflammation.

Buckwheat and Cardiometabolic Health: A Systematic Review and Meta-Analysis

Buckwheat (BW) is suggested to have beneficial effects, but evidence on how it affects cardiometabolic health (CMH) is not yet established. We aimed to assess the effects of BW and/or its related bioactive compounds on cardiovascular disease (CVD) risk markers in adults. Five databases were searched for eligible studies. Observational prospective studies, nonrandomized or randomized trials were considered if they assessed BW, rutin or quercetin-3-glucoside intake and CVD risk markers. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for reporting. We selected 16 human studies based on 831 subjects with mild metabolic disturbances, such as hypercholesterolemia, diabetes and/or overweight. Eight studies, investigating primarily grain components, were included in the meta-analyses (n = 464). High study heterogeneity was present across most of our analyses. Weighted mean difference (WMD) for subjects receiving BW supplementation, compared to controls, were - 0.14 mmol/L (95% CI: -0.30; 0.02) for total cholesterol (TC), -0.03 mmol/L (95% CI: -0.22; 0.16) for LDL cholesterol, -0.14 kg (95% CI: -1.50; 1.22) for body weight, -0.04 mmol/L (95% CI: - 0.09;0.02) for HDL cholesterol, -0.02 mmol/L (95% CI: -0.15; 0.11) for triglycerides and -0.18 mmol/L (95% CI: -0.36; 0.003) for glucose. Most of the studies (66.7%) had concerns of risk of bias. Studies investigating other CVD markers were scarce and with inconsistent findings, where available. Evidence on how BW affects CMH is limited. However, the available literature indicates that BW supplementation in mild dyslipidaemia and type 2 diabetes may provide some benefit in lowering TC and glucose, albeit non-significant. Our work highlights the need for more rigorous trials, with better methodological rigor to clarify remaining uncertainties on potential effects of BW on CMH and its utility in clinical nutrition practice.

Dietary Influences on Gut Microbiota with a Focus on Metabolic Syndrome

There is a clear correlation between gut microbiota, diet, and metabolic outcomes. A diet high in fiber has been shown to decrease inflammation, increase insulin sensitivity, and reduce dyslipidemias whereas a diet high in fat and sugar leads to dyslipidemia, insulin resistance, and low-grade inflammation. There is recent evidence suggesting that the human gut microbiota has a significant role in the development or the resolution of metabolic syndrome (MetS) and associated conditions. Leading a stressful, sedentary lifestyle with limited or no physical activity and consuming an unhealthy diet high in saturated fat, simple carbohydrates, and sodium and low in dietary fiber and in high-quality protein are some of the contributing factors. Unhealthy diets have been shown to induce alterations in the gut microbiota and contribute to the pathogenesis of MetS by altering microbiota composition and disrupting the intestinal barrier, which leads to low-grade systemic inflammation. In contrast, healthy diets can lead to changes in microbiota that increase gut barrier function and increase the production of anti-inflammatory biomarkers. This review aims at providing a more in-depth discussion of diet-induced dysbiosis of the gut microbiota and its effect on MetS. Here, we discuss the possible mechanisms involved in the development of the metabolic biomarkers that define MetS, with an emphasis on the role of sugar and dietary fiber in microbiome-mediated changes in low-grade systemic inflammation and metabolic dysfunction.

Tomato pomace waste as safe feed additive for poultry health and production – a review

Tomato cultivation and industrial processing produce a considerable amount of tomato pomace, peels, and seeds, which are difficult to handle. These by-products contain a variety of minerals and bioactive substances, and may thus be further valorized, generating additional revenue for processing plants while also decreasing environmental issues caused by their buildup. The inclusion of tomato pomace in poultry feed has been shown to produce promising effects in poultry growth and health, however the results are largely inconsistent. Literature has documented improvement in growth, egg production and quality, immunological and antioxidant effects in poultry. This review has complied the impacts of tomato pomace on the growth and health indices of poultry.

Effectiveness of simplified diabetes nutrition education on glycemic control and other diabetes-related outcomes in patients with type 2 diabetes mellitus

BACKGROUND & AIMS

The study aimed to evaluate the effectiveness of the Simplified Diabetes Nutrition Education (SDNE) on glycemic control and other diabetes-related outcomes in patients with type 2 diabetes mellitus (T2DM).

METHODS

This a randomized controlled trial (RCT) randomized 208 patients with T2DM [mean age = 48.8 ± 11.8 years, Glycated Hemoglobin (HbA1c) = 9.5 ± 2.4%, and Body Mass Index = 28.0 ± 5.6 kg/m²] to intervention group (n = 104) or control group (n = 104). Participants in the intervention group received a weekly diabetes nutrition module based on the health belief model for 12 weeks in addition to the usual care whereas the control participants were given the usual care. We evaluated HbA1c and diabetes-related outcomes (metabolic parameters, dietary intake, and physical activity level) at baseline, 12 weeks, and 22 weeks. Health beliefs, diabetes knowledge, and health literacy were also evaluated.

RESULTS

After 22 weeks, HbA1c improved significantly in the intervention group (-1.7%) from the baseline value, compared to the control group (+0.01%) (p < 0.001). Furthermore, the intervention group also showed better improvement in metabolic parameters than the control group (p < 0.05). Besides, dietary intake and physical activity levels improved significantly among the intervention group compared to the control group (p < 0.05). Likewise, health beliefs, diabetes knowledge, and health literacy also improved significantly in the intervention group compared to the control group (p < 0.05).

CONCLUSION

SDNE improves glycemic control and other diabetes-related outcomes among the intervention group compared to the control group.

TRIAL REGISTRATION

ClinicalTrials.gov with ID: NCT04433598. Registered on 16 June 2020 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04433598.

Fibre Intake Is Associated with Cardiovascular Health in European Children

BACKGROUND

We aimed at analysing the association between dietary fibre intake during childhood and cardiovascular health markers.

METHODS

We used observational longitudinal analysis and recorded diet using 3-day diaries at the ages of 3, 4, 5, 6, and 8 years in children from the EU Childhood Obesity Project Trial. At the age of 8, waist circumference, systolic and diastolic blood pressure (SBP and DBP) and biochemical analyses (lipoproteins, triglycerides and homeostasis model for insulin resistance (HOMA-IR)) were evaluated. Those parameters were combined into a cardiometabolic risk score through the sum of their internal z-scores.

RESULTS

Four-hundred children (51.8% girls) attended to the 8-year visit with a 3-day diary. Adjusted linear regression models showed that children who repeatedly stayed in the lowest tertile of fibre intake during childhood had higher HOMA-IR (p = 0.004), higher cardiometabolic risk score (p = 0.02) and a nonsignificant trend toward a higher SBP at 8 years. The higher the dietary intake of soluble fibre (from fruits and vegetables) at 8 years, the lower the HOMA-IR and the cardiometabolic risk score (p = 0.002; p = 0.004). SBP was directly associated with fibre from potatoes and inversely with fibre from nuts and pulses.

CONCLUSION

A diet rich in dietary fibre from fruits, vegetables, pulses and nuts from early childhood was associated to a healthier cardiovascular profile, regardless of children's weight.

Unraveling Host-Gut Microbiota Dialogue and Its Impact on Cholesterol Levels

Disruption in cholesterol metabolism, particularly hypercholesterolemia, is a significant cause of atherosclerotic cardiovascular disease. Large interindividual variations in plasma cholesterol levels are traditionally related to genetic factors, and the remaining portion of their variance is accredited to environmental factors. In recent years, the essential role played by intestinal microbiota in human health and diseases has emerged. The gut microbiota is currently viewed as a fundamental regulator of host metabolism and of innate and adaptive immunity. Its bacterial composition but also the synthesis of multiple molecules resulting from bacterial metabolism vary according to diet, antibiotics, drugs used, and exposure to pollutants and infectious agents. Microbiota modifications induced by recent changes in the human environment thus seem to be a major factor in the current epidemic of metabolic/inflammatory diseases (diabetes mellitus, liver diseases, inflammatory bowel disease, obesity, and dyslipidemia). Epidemiological and preclinical studies report associations between bacterial communities and cholesterolemia. However, such an association remains poorly investigated and characterized. The objectives of this review are to present the current knowledge on and potential mechanisms underlying the host-microbiota dialogue for a better understanding of the contribution of microbial communities to the regulation of cholesterol homeostasis.

Supplementation of Inulin with Various Degree of Polymerization Ameliorates Liver Injury and Gut Microbiota Dysbiosis in High Fat-Fed Obese Mice

The chain length of fructan determines its different physiological effects. This study is to explore the effects of low-performance inulin [LPI, degree of polymerization (DP) ≤ 9] and high-performance inulin (HPI, DP ≥ 23) on obesity-associated liver injury of high-fat diet (HFD) feeding mice and its underlying mechanism. Eight weeks of supplementation of C57BL/6J mice with HPI, relative to LPI (p < 0.05), caused the more efficient improvement against the HFD-induced liver insulin resistance through activating IRS1/PI3K/Akt pathway and reduced protein expressions of inflammatory factors nuclear factor-kappaB (NF-κB) and interleukin-6 (IL-6) in the liver. HPI exhibited the more positive effects on liver steatosis by inhibiting acetyl-CoA carboxylase (ACC), fatty acid synthase (FAS), and sterol regulatory element binding protein 1 (SREBP1) in comparison with LPI (p < 0.05). HPI also increased acetic acid, propionic acid, and butyric acid levels in the colon of HFD-fed mice (p < 0.05). Compared to LPI, HPI feeding of HFD-fed mice led to the more effective decrease in the Firmicutes abundance from 72.1% to 34.5%, but a more significant increase in the Bacteroidetes population from 19.8 to 57.1% at the phyla level, and increased the abundance of Barnesiella, Bacteroides, and Parabacteroides at the genus level (p < 0.05). Depending on DP, HPI exerts the more positive regulation on liver injury and gut microbiota dysfunction than LPI.

Legume Consumption and Cardiometabolic Health

Legumes are key components of several plant-based diets and are recognized as having a wide range of potential health benefits. Previous systematic reviews and meta-analyses have summarized the evidence regarding different cardiometabolic outcomes, such as cardiovascular disease (CVD) and type 2 diabetes (T2D), and legume consumption. However, those studies did not differentiate between nonsoy and soy legumes, which have different nutritional profiles. The aim of the present updated review, therefore, was to summarize and meta-analyze the published evidence regarding legume consumption (making a distinction between nonsoy and soy legumes) and cardiometabolic diseases. In addition, we reviewed randomized clinical trials assessing the effect of legume consumption on CVD risk factors in order to understand their associations. The results revealed a prospective, significant inverse association between total legume consumption and CVD and coronary heart disease risk, whereas a nonsignificant association was observed with T2D and stroke. In the stratified analysis by legume subtypes, only nonsoy legumes were associated with lower risk of T2D. Unfortunately, owing to the paucity of studies analyzing legumes and CVD, it was not possible to stratify the analysis for these outcomes. Because of the high degree of heterogeneity observed for most of the outcomes and the few studies included in some analyses, further prospective studies are warranted to determine the potential role of legume consumption on CVD and T2D.

The Effect of Soluble Fiber Supplementation on Metabolic Syndrome Profile among Newly Diagnosed Type 2 Diabetes Patients

Diets with high fiber content improve most metabolic syndrome (MetS) profile in non-diabetic individuals, but there is scarce information about the role of fiber intake in patients with the MetS and diabetes. The objective of this study is to determine whether soluble fiber supplementation improve MetS profile for 8 weeks of intervention in newly diagnosed type 2 diabetes (T2D) adult patients. After one week of dietary stabilization phase, 36 newly diagnosed T2D patients were stratified to different strata according to sex, age, fasting blood sugar (FBS), and waist circumference (WC). Then they were randomly allocated into 2 groups. The psyllium group (n = 18) received 10.5 g of psyllium daily for 8 weeks. The control group (n = 18) maintained their regular diet for 8 weeks. Soluble fiber supplementation showed significant reduction in the majority of MetS profile; FBS (43.55 mg/dL, p < 0.001), triglyceride (37.89 mg/dL, p < 0.001), total cholesterol (20.32 mg/dL, p < 0.001), systolic blood pressure (7.50 mmHg, p < 0.001), diastolic blood pressure (2.78 mmHg, p = 0.013), and WC (2.54 cm, p < 0.001) in the intervention group compared with the control group after 8 weeks of intervention. The high-density lipoprotein cholesterol was reduced in both groups, but this reduction was insignificant. The improvement in the MetS profile was enhanced by combining psyllium to the normal diet. Consumption of foods containing moderate amounts of these fibers may improve MetS profile in newly diagnosed T2D patients. This study was registered in Current Controlled Trials (PHRC/HC/28/15).

A systematic review and narrative synthesis of interventions for uncomplicated obesity: weight loss, well-being and impact on eating disorders

OBJECTIVE

Most weight loss research focuses on weight as the primary outcome, often to the exclusion of other physiological or psychological measures. This study aims to provide a holistic evaluation of the effects from weight loss interventions for individuals with obesity by examining the physiological, psychological and eating disorders outcomes from these interventions.

METHODS

Databases Medline, PsycInfo and Cochrane Library (2011-2016) were searched for randomised controlled trials and systematic reviews of obesity treatments (dietary, exercise, behavioural, psychological, pharmacological or surgical). Data extracted included study features, risk of bias, study outcomes, and an assessment of treatment impacts on physical, psychological or eating disorder outcomes.

RESULTS

From 3628 novel records, 134 studies met all inclusion criteria and were evaluated in this review. Lifestyle interventions had the strongest evidence base as a first-line approach, with escalation to pharmacotherapy and bariatric surgery in more severe or complicated cases. Quality of life was the most common psychological outcome measure, and improved in all cases where it was assessed, across all intervention types. Behavioural, psychological and lifestyle interventions for weight loss led to improvements in cognitive restraint, control over eating and binge eating, while bariatric surgery led to improvements in eating behaviour and body image that were not sustained over the long-term.

DISCUSSION

Numerous treatment strategies have been trialled to assist people to lose weight and many of these are effective over the short-term. Quality of life, and to a lesser degree depression, anxiety and psychosocial function, often improve alongside weight loss. Weight loss is also associated with improvements in eating disorder psychopathology and related measures, although overall, eating disorder outcomes are rarely assessed. Further research and between-sector collaboration is required to address the significant overlap in risk factors, diagnoses and treatment outcomes between obesity and eating disorders.

Fruit and vegetable consumption and risk of cardiovascular disease: A meta-analysis of prospective cohort studies

A meta-analysis of prospective cohort studies was conducted to examine the relation between fruit and vegetables (FV) consumption and the risk of cardiovascular disease (CVD). We searched PubMed and EMBASE up to June 2014 for relevant studies. Pooled relative risks (RRs) were calculated and dose-response relationship was assessed. Thirty-eight studies, consisting of 47 independent cohorts, were eligible in this meta-analysis. There were 1,498,909 participants (44,013 CVD events) with a median follow-up of 10.5 years. The pooled RR (95% confidence interval) of CVD for the highest versus lowest category was 0.83 (0.79-0.86) for FV consumption, 0.84 (0.79-0.88) for fruit consumption, and 0.87 (0.83-0.91) for vegetable consumption, respectively. Dose-response analysis showed that those eating 800 g per day of FV consumption had the lowest risk of CVD. Our results indicate that increased FV intake is inversely associated with the risk of CVD. This meta-analysis provides strong support for the current recommendations to consume a high amount of FV to reduce CVD risk.

Dietary fat content modulates the hypolipidemic effect of dietary inulin in rats

SCOPE

Dietary fat content (low versus high fat) may modulate the serum lipid-lowering effect of high-performance (HP)-inulin. This study investigated the effect of dietary HP-inulin on metabolism in rats fed a low- or high-fat diet.

METHODS AND RESULTS

Rats were fed a diet of 5% fat with 5% cellulose or 5% HP-inulin (average degree of polymerization = 24) (low-fat diet) or of 20% fat with 5% cellulose or 5% HP-inulin (high-fat diet) for 28 days. Total, HDL, and non-HDL cholesterols, and triglyceride concentrations in the serum were measured along with total lipid content of liver and feces. Hepatic triglyceride and cholesterol, and fecal neutral and acidic sterol concentrations in total lipid were assessed. In addition, cecum SCFA levels and bacterial profiles were determined. The hypolipidemic effect of HP-inulin differed depending on dietary fat content (5% versus 20%). Specifically, 5% inulin instead of cellulose in a semi-purified diet significantly reduced serum lipid levels in rats fed a high-fat diet, which was strongly associated with increased total lipid and neutral sterol excretion.

CONCLUSION

Dietary fat content modulates the hypolipidemic effect of dietary inulin.

Can pulses play a role in improving cardiometabolic health? Evidence from systematic reviews and meta-analyses

Obesity, diabetes, and cardiovascular disease (CVD) present important unmet prevention and treatment challenges. Dietary pulses are sustainable, affordable, and nutrient-dense foods that have shown a wide range of health benefits in the prevention and management of these conditions. Despite these findings, recommendations for pulse intake continue to vary across chronic disease guidelines, and intake levels continue to remain low. Here, we summarize findings from recent systematic reviews and meta-analyses assessing the relationship between dietary pulse consumption and cardiometabolic health and assess the overall strength of the evidence using the Grading of Recommendations, Assessment, Development, and Evaluation tool. We conclude that systematic reviews and meta-analyses of prospective cohort studies assessing the relationship between legumes and the risk of coronary heart disease appear to provide moderate-quality evidence of a benefit, and several systematic reviews and meta-analyses of randomized controlled trials assessing the effect of pulses on cardiometabolic risk factors provide low- to moderate-quality evidence of a benefit. There remains an urgent need, however, for more high-quality prospective cohort studies and large, high-quality, randomized trials to clarify the benefits of dietary pulses in the prevention and management of overweight/obesity, diabetes, and CVD.

Red algae (Gelidium amansii) hot-water extract ameliorates lipid metabolism in hamsters fed a high-fat diet

The purpose of this study was to investigate the effects of Gelidium amansii (GA) hot-water extracts (GHE) on lipid metabolism in hamsters. Six-week-old male Syrian hamsters were used as the experimental animals. Hamsters were divided into four groups: (1) control diet group (CON); (2) high-fat diet group (HF); (3) HF with GHE diet group (HF + GHE); (4) HF with probucol diet group (HF + PO). All groups were fed the experimental diets and drinking water ad libitum for 6 weeks. The results showed that GHE significantly decreased body weight, liver weight, and adipose tissue (perirenal and paraepididymal) weight. The HF diet induced an increase in plasma triacylglycerol (TG), total cholesterol (TC), low-density lipoprotein cholesterol and very-low-density lipoprotein cholesterol levels. However, GHE supplementation reversed the increase of plasma lipids caused by the HF diet. In addition, GHE increased fecal cholesterol, TG and bile acid excretion. Lower hepatic TC and TG levels were found with GHE treatment. GHE reduced hepatic sterol regulatory element-binding proteins (SREBP) including SREBP 1 and SREBP 2 protein expressions. The phosphorylation of adenosine monophosphate (AMP)-activated protein kinase (AMPK) protein expression in hamsters was decreased by the HF diet; however, GHE supplementation increased the phosphorylation of AMPK protein expression. Our results suggest that GHE may ameliorate lipid metabolism in hamsters fed a HF diet.

Associations between Dietary Fiber Intake in Infancy and Cardiometabolic Health at School Age: The Generation R Study

Dietary fiber (DF) intake may be beneficial for cardiometabolic health. However, whether this already occurs in early childhood is unclear. We investigated associations between DF intake in infancy and cardiometabolic health in childhood among 2032 children participating in a population-based cohort in The Netherlands. Information on DF intake at a median age of 12.9 months was collected using a food-frequency questionnaire. DF was adjusted for energy intake using the residual method. At age 6 years, body fat percentage, high-density lipoprotein (HDL)-cholesterol, insulin, triglycerides, and blood pressure were assessed and expressed in age- and sex-specific standard deviation scores (SDS). These five factors were combined into a cardiometabolic risk factor score. In models adjusted for several parental and child covariates, a higher DF intake was associated with a lower cardiometabolic risk factor score. When we examined individual cardiometabolic factors, we observed that a 1 g/day higher energy-adjusted DF intake was associated with 0.026 SDS higher HDL-cholesterol (95% CI 0.009, 0.042), and 0.020 SDS lower triglycerides (95% CI −0.037, −0.003), but not with body fat, insulin, or blood pressure. Results were similar for DF with and without adjustment for energy intake. Our findings suggest that higher DF intake in infancy may be associated with better cardiometabolic health in later childhood.

Spirogyra neglecta inhibits the absorption and synthesis of cholesterol in vitro

Background

Spirogyra neglecta (SN) has many nutritional benefits and it is commonly used to ameliorate different human conditions including inflammation, gastric ulcer, hyperglycemia, and hyperlipidemia. However, the mechanism of the hypocholesterolemic effect of SN still remains unclear. Therefore, the present study was aimed to evaluate the effect of SN extract particularly on cholesterol absorption and synthesis mechanisms.

Methods

For cholesterol absorption, the uptake of cholesterol was measured by using tritium radiolabeling of cholesterol in Caco-2 cells. Bile acid binding, micelles size, and cholesterol solubility were analyzed in in vitro assays, while cholesterol synthesis was evaluated by using a 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase assay kit.

Results

SN extract was found to decrease cholesterol uptake in Caco-2 cells and decreased the solubility of cholesterol in micelles. The SN extract bound to taurocholate, taurodeoxycholate, and glycodeoxycholate bile acids, and increased micelles size. SN has also demonstrated an inhibitory effect on HMG-CoA reductase (HMGR) enzymatic activity. For further experimentation, the treatment combination of SN and ezetimibe (0.04 mg/mL) showed a greater significant reduction in cholesterol uptake than the extract alone.

Conclusion

These observations suggested that inhibitory cholesterol absorption effects of SN could be mediated through the modulation of size and solubility of cholesterol micelles, resulting in interference of cholesterol uptake. In addition, SN inhibited the rate limiting step of cholesterol synthesis. This study provides supporting evidence for the potential usage of SN as a cholesterol lowering agent.

Consumption of various forms of apples is associated with a better nutrient intake and improved nutrient adequacy in diets of children: National Health and Nutrition Examination Survey 2003-2010

Background

Consumption of fruit has been associated with a variety of health benefits, yet, 75% of children have usual intakes of total fruit below minimum recommended amounts. Apples are the second most commonly consumed fruit in the United States; however, no studies have examined the impact of apple consumption on nutrient intake and adequacy in children's diets.

Objective

The purpose of this study is to examine the association between apple (various forms) consumption with nutrient intake and nutrient adequacy in a nationally representative sample of children.

Design

Participants were children aged 2–18 years (n=13,339), from the National Health and Nutrition Examination Survey 2003–2010. Least square means of total energy and nutrient intake, and the percentage of the population below the estimated average requirement (EAR) or above the adequate intake (AI) among apple consumers and non-consumers were examined.

Results

Consumers of total apple products had higher (p<0.01) total intakes of fiber, magnesium, and potassium and lower intakes of total fat, saturated fatty acids, monounsaturated fatty acid, and sodium than non-consumers. Apple consumers had higher (p<0.01) total sugar intake, but lower intake of added sugars compared to non-consumers. A lower (p<0.01) percentage of apple consumers were below the EAR for 13 of the 16 nutrients studied. Apple consumers had approximately a 10 percentage unit difference below the EAR for calcium and magnesium, and vitamins A, C, D, and E, than non-consumers. The percentage above the AI for fiber was significantly (p<0.0001) higher among total apple consumers (6.24±0.45 g) compared to non-consumers (0.57±0.07 g). The results were similar for individual apple products (i.e. apple juice, applesauce, and whole apples).

Conclusion

Consumption of any forms of apples provided valuable nutrients in the diets of children.

Effects of various fibre-rich extracts on cholesterol binding capacity during in vitro digestion of pork patties

Intake of foods containing high levels of cholesterol harms human health, and an increase in the intake of dietary fibre (DF) may mitigate these negative effects.

Association of dietary fiber intake with serum total cholesterol and low density lipoprotein cholesterol levels in Urban Asian-Indian adults with type 2 diabetes

CONTEXT

There is little data correlating dietary fibre (DF) intake and cardiovascular risk in Asian Indians with diabetes.

AIM

To assess the DF intake and its association with lipid profile (total serum cholesterol and low density lipoprotein [LDL] - cholesterol levels) in urban Asian Indians with diabetes.

SUBJECTS AND METHODS

Dietary assessment using validated Food Frequency Questionnaire was conducted in 1191 free-living adults with known diabetes in the Chennai Urban Rural Epidemiology Study. Subjects taking medication for dyslipidemia, and those with cardiovascular disease and implausible energy intake (n = 262) were excluded, leaving 929 participants. Anthropometric and relevant biochemical parameters were measured using standardized techniques.

RESULTS

Diabetic individuals who consumed DF < median intake (29 g/day) had a higher prevalence of hypercholesterolemia (49.5% vs. 40.1% [P = 0.01]) and higher LDL cholesterol (46.2% vs. 35.5% [P = 0.001]) than those in the > median intake of DF group. The risk of hypercholesterolemia (odds ratio [OR] =1.38 [95% confidence interval [CI]: 1.02-1.85], P = 0.04), and high LDL cholesterol (OR: 1.43 [95% CI: 1.06-1.94], P = 0.02) was higher among those whose DF intake was less than the median. Serum triglycerides and high density lipoprotein cholesterol were not associated with DF intake. The main sources of DF were vegetables and legumes.

CONCLUSION

In urban Asian Indians with diabetes, lower DF intake is positively related to total cholesterol and LDL cholesterol levels.

Safety and efficacy of glucomannan for weight loss in overweight and moderately obese adults

BACKGROUND

Few safe and effective dietary supplements are available to promote weight loss. We evaluated the safety and efficacy of glucomannan, a water-soluble fiber supplement, for achieving weight loss in overweight and moderately obese individuals consuming self-selected diets.

METHODS

Participants were randomly assigned to take 1.33 grams of glucomannan or identically looking placebo capsules with 236.6 mL (8 ounces) of water one hour before breakfast, lunch, and dinner for 8 weeks. The primary efficacy outcome was change in body weight after 8 weeks. Other efficacy outcomes were changes in body composition, hunger/fullness, and lipid and glucose concentrations. Safety outcomes included gastrointestinal symptoms/tolerance and serum liver enzymes and creatinine levels.

RESULTS

A total of 53 participants (18-65 years of age; BMI 25-35 kg/m²) were enrolled and randomized. The two groups did not differ with respect to baseline characteristics and compliance with the study supplement. At 8 weeks, there was no significant difference between the glucomannan and placebo groups in amount of weight loss (-.40 ± .06 and -.43 ± .07, resp.) or other efficacy outcomes or in any of the safety outcomes.

CONCLUSIONS

Glucomannan supplements administered over 8 weeks were well tolerated but did not promote weight loss or significantly alter body composition, hunger/fullness, or lipid and glucose parameters. This trial is registered with NCT00613600.

Effect of the combinations between pea proteins and soluble fibres on cholesterolaemia and cholesterol metabolism in rats

Many functional foods and dietary supplements have been reported to be beneficial for the management of dyslipidaemia, one of the major risk factors for CVD. Soluble fibres and legume proteins are known to be a safe and practical approach for cholesterol reduction. The present study aimed at investigating the hypocholesterolaemic effect of the combinations of these bioactive vegetable ingredients and their possible effects on the expression of genes regulating cholesterol homeostasis. A total of six groups of twelve rats each were fed, for 28 d, Nath's hypercholesterolaemic diets, differing in protein and fibre sources, being, respectively, casein and cellulose (control), pea proteins and cellulose (pea), casein and oat fibres (oat), casein and apple pectin (pectin), pea proteins and oat fibres (pea+oat) and pea proteins and apple pectin (pea+pectin). Administration of each vegetable-containing diet was associated with lower total cholesterol concentrations compared with the control. The combinations (pea+oat and pea+pectin) were more efficacious than fibres alone in modulating cholesterolaemia ( - 53 and - 54%, respectively, at 28 d; P< 0·005). In rats fed the diets containing oat fibres or apple pectin, alone or in combination with pea proteins, a lower hepatic cholesterol content (P< 0·005) and higher hepatic mRNA concentrations of CYP7A1 and NTCP were found when compared with the control rats (P< 0·05). In summary, the dietary combinations of pea proteins and oat fibres or apple pectin are extremely effective in lowering plasma cholesterol concentrations in rats and affect cellular cholesterol homeostasis by up-regulating genes involved in hepatic cholesterol turnover.

Improvement effect of resistant maltodextrin in humans with metabolic syndrome by continuous administration

Resistant maltodextrin (RMD) is a soluble dietary fiber ingredient whose physiological functions are well recognized in Foods for Specified Health Use (FOSHU) for maintaining healthy intestinal regularity, blood glucose levels, and serum lipids. However, its efficacy on combined health risks--metabolic syndrome--was not studied yet. In this study the efficacy of RMD on humans with metabolic syndrome was investigated. A randomized double-blind placebo-controlled parallel-group trial was conducted. Thirty subjects with metabolic syndrome were randomly allocated into 2 groups and took either tea containing 9 g of RMD (treatment group) or placebo tea at three mealtimes daily for 12 wk. Blood was collected and body fat was scanned periodically. In the RMD treatment group, waist circumference, visceral fat area, fasting blood glucose, HOMA-R and serum triacylglycerol (TG) were significantly decreased compared to baseline, and significant time-by-treatment interaction was observed for waist circumference, visceral fat area, HOMA-R and serum TG (p=0.044, p=0.012, p=0.032, and p=0.049, respectively). The change ratio of visceral fat area showed negative statistical correlation with the baseline value (p=0.033), suggesting that efficacy of RMD was emphasized in the subjects having a larger visceral fat area. After the 12-wk RMD treatment, the total number of metabolic syndrome risk factors decreased to 20 from 32 with 2 subjects having no risks, while that of the placebo group decreased to 25 from 32. These findings suggest that continuous ingestion of RMD may improve the risk factors of metabolic syndrome by reducing visceral fat and improving glucose and lipid metabolism.

Molecular mechanisms involved in the bidirectional relationship between diabetes mellitus and periodontal disease

Both diabetes and periodontitis are chronic diseases. Diabetes has many adverse effects on the periodontium, and conversely periodontitis may have deleterious effects further aggravating the condition in diabetics. The potential common pathophysiologic pathways include those associated with inflammation, altered host responses, altered tissue homeostasis, and insulin resistance. This review examines the relationship that exists between periodontal diseases and diabetes mellitus with a focus on potential common pathophysiologic mechanisms.

Protective effect of dietary tender cluster beans (Cyamopsis tetragonoloba) in the gastrointestinal tract of experimental rats

In this study, the gastrointestinal protective effect of soluble, dietary fiber-rich tender cluster beans, with respect to the activities of antioxidant enzymes and the concentration of antioxidant molecules, was examined in Wistar rats. Dietary intervention with tender cluster beans (15% freeze-dried powder in the diet for 8 weeks) significantly enhanced the activities of antioxidant enzymes (superoxide dismutase, catalase, glutathione reductase, glutathione-S-transferase, and GPX) and the concentrations of antioxidant molecules in both gastric and intestinal mucosa. Further, in combination with capsaicin (0.01%), the beneficial effect was even higher. There is a strong indication that tender cluster beans offer a significant gastroprotective effect, and a much greater effect when combined with capsaicin in terms of increased antioxidant status. In a separate study, these dietary components were found to alleviate the diminished activities of antioxidant enzymes and antioxidant molecules in gastric and intestinal mucosa under conditions of ethanol-induced oxidative stress. The gastroprotective effect of the cluster bean was also reflected in its positive effect on gastric mucosal glycoproteins, resulting in a lowering of mucosal injury. Incidentally, the serum and liver also showed an elevated antioxidant status, thus suggesting desirable lowered oxidative stress results when tender cluster beans are consumed.

Prebiotics to fight diseases: reality or fiction?

Bacteria living in the gastrointestinal tract are crucial for human health and disease occurrence. Increasing the beneficial intestinal microflora by consumption of prebiotics, which are 'functional foods', could be an elegant way to limit the number and incidence of disorders and to recover from dysbiosis or antibiotic treatments. This review focuses on the short-chain low-digestible carbohydrates (LDCs) which are metabolized by gut microbiota serving as energy source, immune system enhancers or facilitators of mineral uptake. Intake of foods containing LDCs can improve the state of health and may prevent diseases as for example certain forms of cancer. Given the large number of different molecules belonging to LDCs, we focused our attention on fructans (inulin, fructo-oligosaccharides), galacto-oligosaccharides and resistant starches and their therapeutic and protective applications. Evidence is accumulating that LDCs can inhibit bacterial and viral infections by modulating host defense responses and by changing the interactions between pathogenic and beneficial bacteria. Animal studies and studies on small groups of human subjects suggest that LDCs might help to counteract colorectal cancer, diabetes and metabolic syndrome. The action mechanisms of LDCs in the human body might be broader than originally thought, perhaps also including reactive oxygen species scavenging and signaling events.

Dietary cholesterol affects plasma lipid levels, the intravascular processing of lipoproteins and reverse cholesterol transport without increasing the risk for heart disease

The associations between dietary cholesterol and heart disease are highly controversial. While epidemiological studies and clinical interventions have shown the lack of correlation between cholesterol intake and cardiovascular disease (CVD) risk, there is still concern among health practitioners and the general population regarding dietary cholesterol. In this review, several clinical studies utilizing cholesterol challenges are analyzed in terms of changes that occur in lipoprotein metabolism resulting from excess consumption of cholesterol. Dietary cholesterol has been shown to increase both LDL and HDL in those individuals who respond to a cholesterol challenge without altering the LDL cholesterol/HDL cholesterol ratio, a key marker of CVD risk. Further, dietary cholesterol has been shown to increase only HDL with no changes in LDL with average cholesterol consumption and during weight loss interventions. Ingestion of cholesterol has also been shown to increase the size of both LDL and HDL particles with the associated implications of a less atherogenic LDL particle as well as more functional HDL in reverse cholesterol transport. Other changes observed in lipoprotein metabolism are a greater number of large LDL and decreases in small LDL subfractions. All this information put together points to specific roles of dietary cholesterol in substantially altering intravascular processing of lipoproteins as well as reverse cholesterol transport.

Polymorphisms in LEP and NPY genes modify the response to soluble fibre Plantago ovata husk intake on cardiovascular risk biomarkers

The satiating effect of fibre consumption has been related to gut hormones, such as peptide YY and leptin. These peptides may also influence cardiovascular (CVD) risk biomarkers. Nevertheless, there is wide interindividual variation in metabolic responses to fibre consumption. The objective was to investigate differences in the effects of soluble fibre, in the form of Plantago ovata husk (Po-husk) treatment, on CVD risk biomarkers according to selected polymorphisms in genes related to satiety. The study was a multi-centred, double-blind, placebo-controlled, parallel and randomised trial in mild-moderate hypercholesterolaemic patients (age range: 43-67 years). Eight polymorphisms in three genes related to satiety (LEP, NPY and PYY) were identified in 178 participants; 88 patients in the placebo (microcrystalline cellulose 14 g/day) group and 90 in the Po-husk (14 g/day) group, which had added to a low-saturated-fat diet for 8 weeks. The CVD biomarkers measured included the following: lipid profile, blood pressure (BP), glucose, insulin, hs-CRP, oxidised LDL and IL-6. Relative to the placebo, Po-husk consumption lowered the plasma total cholesterol concentration by 3.3 % according to rs7799039 polymorphism in the LEP gene (p < 0.05). Furthermore, the Po-husk reduced systolic BP (mean [95 % CI]) by -8 mmHg (-14.16; -1.90) and hs-CRP by 24.9 % in subjects with the AA genotype of the rs16147 polymorphism in the NPY gene (32 % of our total population; p < 0.05), which remained significant after Bonferroni correction. In conclusion, polymorphisms in the LEP and NPY genes potentiate the response to Po-husk, particularly the effects on systolic BP and the hs-CRP plasma concentration.

Dietary fibers and cardiometabolic diseases

The high prevalence of cardiovascular disease (CVD) is largely attributable to the contemporary lifestyle that is often sedentary and includes a diet high in saturated fats and sugars and low ingestion of polyunsaturated fatty acids (PUFAs), fruit, vegetables, and fiber. Experimental data from both animals and humans suggest an association between increased dietary fiber (DF) intakes and improved plasma lipid profiles, including reduced low density lipoprotein cholesterol (LDL-C) concentrations. These observations underline that the intake of DF may protect against heart disease and stroke.

Astragalus polysaccharides lowers plasma cholesterol through mechanisms distinct from statins

To determine the efficacy and underlying mechanism of Astragalus polysaccharides (APS) on plasma lipids in hypercholesterolemia hamsters. The effect of APS (0.25g/kg/d) on plasma and liver lipids, fecal bile acids and neutral sterol, cholesterol absorption and synthesis, HMG-CoA reductase activity, and gene and protein expressions in the liver and small intestine was investigated in twenty-four hypercholesterolemia hamsters. Treatment periods lasted for three months. APS significantly lowered plasma total cholesterol by 45.8%, triglycerides by 30%, and low-density lipoprotein-cholesterol by 47.4%, comparable to simvastatin. Further examinations revealed that APS reduced total cholesterol and triglycerides in the liver, increased fecal bile acid and neutral sterol excretion, inhibited cholesterol absorption, and by contrast, increased hepatic cholesterol synthesis and HMG-CoA reductase activity. Plasma total cholesterol or low-density lipoprotein-cholesterol levels were significantly correlated with cholesterol absorption rates. APS up-regulated cholesterol-7α-hydroxylase and LDL-receptor gene expressions. These new findings identify APS as a potential natural cholesterol lowering agent, working through mechanisms distinct from statins.

Cocoa and chocolate in human health and disease

Cocoa contains more phenolic antioxidants than most foods. Flavonoids, including catechin, epicatechin, and procyanidins predominate in antioxidant activity. The tricyclic structure of the flavonoids determines antioxidant effects that scavenge reactive oxygen species, chelate Fe2+ and Cu+, inhibit enzymes, and upregulate antioxidant defenses. The epicatechin content of cocoa is primarily responsible for its favorable impact on vascular endothelium via its effect on both acute and chronic upregulation of nitric oxide production. Other cardiovascular effects are mediated through anti-inflammatory effects of cocoa polyphenols, and modulated through the activity of NF-κB. Antioxidant effects of cocoa may directly influence insulin resistance and, in turn, reduce risk for diabetes. Further, cocoa consumption may stimulate changes in redox-sensitive signaling pathways involved in gene expression and the immune response. Cocoa can protect nerves from injury and inflammation, protect the skin from oxidative damage from UV radiation in topical preparations, and have beneficial effects on satiety, cognitive function, and mood. As cocoa is predominantly consumed as energy-dense chocolate, potential detrimental effects of overconsumption exist, including increased risk of weight gain. Overall, research to date suggests that the benefits of moderate cocoa or dark chocolate consumption likely outweigh the risks.